Pyromania Impulse Control Disorder

Abstract
Pyromania is an impulse control disorder categorized by the DSM-5 as “deliberate and purposeful fire-setting on more than one occasion” combined with “tension or affective arousal”, “pleasure, gratification or relief when setting fires or when witnessing or participating in their aftermath” (American Psychiatric Association, 2013). Also, those diagnosed with pyromania aren’t setting fires for monetary gain, to conceal crimes, as an expression of emotion or ideology, or because of impaired judgment associated with disorders, disabilities or substance abuse (American Psychiatric Association, 2013). There have not been many quantitative studies on the prevalence of pyromania in the population nor its treatment. “…relatively few structured
Pyromania, though observed for many years, still hasn’t yielded the level of research needed to truly assess the rate to which pyromania affects the public nor the necessary methods for treatment or prevention. Pyromania is an impulse control disorder categorized by the DSM-5 as (a) deliberate and purposeful fire-setting on more than one occasion (b) tension or affective arousal, (c) fascination with, interest in, curiosity about, or attraction to fire and its situational contexts, (d) pleasure, gratification or relief when setting fires or when witnessing or participating in their aftermath (e) the fire setting is not done for monetary gain, as an expression of sociopolitical ideology, to conceal criminal activity (f) the fire setting is not better explained by conduct disorder, a manic episode, or antisocial personality disorder (American Psychiatric Association, 2013). Population prevalence of pyromania is not known, most diagnosis has occurred as a comorbid condition rather than a primary diagnosis. Of those “reaching the criminal system with repeated fire setting, only 3.3% had symptoms that met full criteria for pyromania”, as cited by Lindberg et al. in 2005 in the DSM-V (American Psychiatric Association,
231). CBT is a short-term, action focused psychotherapy treatment utilizing interventions that promote practical problem-solving. Dysfunctional thinking and behaviors are modified by learning new skills that challenge negative patterns. There is limited clinical research that examines cognitive-behavioral treatment on all ICDs, however with reference to kleptomania, compulsive buying and pathological gamblers “there is a general consensus in the literature that cognitive-behavioral therapies offer an effective model for intervention for all these disorders” (Hodgins & Peden, 2008, p. 32). CBT has been used in studies in the treatment of kleptomania, utilizing methods such as sensitization, aversion exercises and relaxation training (Hodgins & Peden, 2008). Alternative treatment models have been researched and include pharmacological therapies, however those double-blind studies have only focused on specific ICDs: pathological gambling, intermittent explosive disorder and compulsive shopping (Dell’Osso et al., 2006). Pyromania has yet to have a double-blind study conducted according to Table 3, however there has been some efficacy with non-pharmacological interventions like CBT (Dell’Osso et al.,